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Posterior tibial tendon

Ramón Cugat, Eduard Alentorn-Geli, Xavier Cuscó, Jordi Navarro, Gilbert Steinbacher, Pedro Álvarez-Díaz, Roberto Seijas, David Barastegui, Montse García-Balletbó
Posterior cruciate ligament reconstruction using the transtibial technique provides successful clinical outcomes. However, a bone-patellar tendon-bone (BTB) autograft with the transtibial technique has not been used by some surgeons because of concerns with graft passage from the tibial to the femoral tunnels (sharp turn) that can damage graft fibers. In the present surgical technique, an arthroscopic, transtibial, single-bundle technique for posterior cruciate ligament reconstruction using the BTB autograft with an easy and effective technical tip to facilitate graft passage is presented...
February 2018: Arthroscopy Techniques
Daniel John Cleather
The patella is traditionally understood to be a "joint spacer" that increases the moment arm of the patellar tendon. This characterisation is unsatisfactory as it fails to explain the more interesting characteristics of the patella: 1) that the changing pivot point of the patella causes the ratio of quadriceps to patellar tendon force to almost double as the knee flexes; 2) that the patellar tendon exerts an anteriorly directed force on the tibia when the knee is extended but this switches to a posterior draw as the knee flexes; and 3) that the presence of the patella allows the quadriceps to exert different moments on the femur and tibia...
March 13, 2018: Journal of Theoretical Biology
Tulio Diniz-Fernandes, Alexandre Leme Godoy-Santos, Maria Cristina Santo, Pedro Pontin, Caio Augusto Alves Pereira, Yuri Justi Jardim, Ana Paula Pereira Velosa, Nicola Maffulli, Walcy Rosolia Teodoro, Vera Luiza Capelozzi
Posterior tibial tendinopathy (PTT) can lead to acquired flatfoot in adults. Many patients develop PTT without any identifiable risk factors. Molecular changes in extracellular matrix (ECM) and matrix metalloproteinase (MMP) polymorphism may influence the risk of developing PTT. We aim to investigate the association between matrix metalloproteinase-1 (MMP-1) and (MMP-8) gene polymorphisms with changes in collagen I, III and V in PTT. A case-control study with 22 patients and 5 controls was performed. The MMP-1 (2G/2G) and MMP-8 (T/T) genotypes were determined by PCR-restriction fragment length polymorphism...
March 13, 2018: Histology and Histopathology
Emilio Wagner, Pablo Wagner, Diego Zanolli, Rubén Radkievich, Gunther Redenz, Rodrigo Guzman
BACKGROUND: Tibialis posterior tendon transfer is performed when loss of dorsiflexion has to be compensated. We evaluated the circumtibial (CT), above-retinaculum transmembranous (TMAR), and under-retinaculum transmembranous (TMUR) transfer gliding resistance and foot kinematics in a cadaveric foot model during ankle range of motion (ROM). METHODS: Eight cadaveric foot-ankle distal tibia specimens were dissected free of soft tissues on the proximal end, applying an equivalent force to 50% of the stance phase to every tendon, except for the Achilles tendon...
March 1, 2018: Foot & Ankle International
Christoph Ihle, H Nakayama, Christoph Gonser, Ulrich Stöckle, Stefan Döbele, Steffen Schröter, Marc-Daniel Ahrend, Atesch Ateschrang
BACKGROUND: The established surgical technique for lesion of the anterior cruciate ligament (ACL) is reconstruction with an autologous tendon. However, patients after ACL-replacement have increased osteoarthritis rates. Possible explanations are persistent knee instability and the loss of the ACL's proprioceptive function. Therefore, surgeons have developed an alternative treatment to preserve the ACL by readapting femoral ACL lesions by temporary protective dynamic intraligamentary stabilisation (DIS)...
February 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Alessio Bernasconi, Francesco Sadile, Matthew Welck, Nazim Mehdi, Julien Laborde, François Lintz
BACKGROUND: Stage II tibialis posterior tendon dysfunction (PTTD) resistant to conservative therapies is usually treated with invasive surgery. Posterior tibial tendoscopy is a novel technique being used in the assessment and treatment of posterior tibial pathology. The aims of this study were (1) to clarify the role of posterior tibial tendon tendoscopy in treating stage II PTTD, (2) to arthroscopically classify spring ligament lesions, and (3) to compare the arthroscopic assessment of spring ligament lesions with magnetic resonance imaging (MRI) and ultrasonographic (US) data...
February 1, 2018: Foot & Ankle International
Chu-Zhao Lin, Xue Xia, Hu Wang, Dong-Xin Liu
Children with simultaneous injury to the Achilles tendon and heel skin remain a challenge for clinicians. The purpose of this study is to evaluate a combined surgical procedure involving use of the fascia lata to reconstruct the Achilles tendon, and the posterior tibial artery perforator flap to cover the accompanying heel skin injury.Between February 2010 and February 2013, 8 children (3 females and 5 males) between 3 and 12 years of age, with a median age of 7.5 years, were hospitalized in the First Affiliated Hospital of Shantou University Medical College...
February 2018: Medicine (Baltimore)
Jeffrey Wake, Kevin Martin
Adult acquired flatfoot deformity (AAFD), formerly known as posterior tibial tendon (PTT) dysfunction, is one of the most common problems of the foot and ankle. It was first described as tendon failure but has since been revealed as ligamentous failure in addition. AAFD is a spectrum of deformities that ranges from tenosynovitis (stage I) to AAFD (stages II-IV). Regarding mild stage I and stage II disease, it was once standard to perform an open synovectomy completely removing the inflamed synovium; this procedure required a large 6-cm medial ankle incision...
October 2017: Arthroscopy Techniques
Antonio Viladot Voegeli, Nicolás Fontecilla Cornejo, Juan Andrés Serrá Sandoval, Fernando Alvarez Goenaga, Ramón Viladot Pericé
BACKGROUND: The aim of the study was to evaluate the clinical and radiological results obtained in the treatment of adult flexible flatfoot secondary to posterior tibial dysfunction with subtalar arthroereisis using a Kalix ® endorthesis. METHODS: 35 patients (37 feet) were studied, having been operated between January 2010 and January 2015 for reducible flatfoot secondary to posterior tibial tendon dysfunction stage IIA1 of Bluman. RESULTS: The average follow up was 47...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
T H Lui, C Y D Mak
BACKGROUND: This research studied the safety and efficacy of a new portal to the spring ligament. This portal is located just plantar to the insertion of the posterior tibial tendon and above the fibrous septum between the posterior tibial and the flexor digitorum longus tendons. METHODS: Twelve fresh frozen foot and ankle specimens were used. The distance between the accessory medial portal and the medial plantar nerve was measured. The relation between the medial plantar nerve and the spring ligament was studied...
March 8, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
P Ceccarini, G Rinonapoli, G Gambaracci, M Bisaccia, A Ceccarini, A Caraffa
BACKGROUND: To report on the functional, biomechanical, and radiographic results of patients who had undergone arthroereisis plus tensioning of the posterior tibial tendon for flexible flatfoot. The hypothesis is that arthroereisis associated to a tensioning of the posterior tibial tendon give a good correction with great satisfaction in patients with flexible flatfoot in grade IIA. METHODS: We evaluated 29 patients (31 feet), mean age of 46.4 years, who had been surgically treated for adult flatfoot grade IIA according to Myerson...
April 14, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Jia-Lin Wu, Chian-Her Lee, Chan-Tsung Yang, Chia-Ming Chang, Guoan Li, Cheng-Kung Cheng, Chih-Hwa Chen, Hsu-Shan Huang, Yu-Shu Lai
Transtibial pullout suture (TPS) repair of posterior medial meniscus root (PMMR) tears was shown to achieve good clinical outcomes. The purpose of this study was to compare biomechanically, a novel technique designed to repair PMMR tears using tendon graft (TG) and conventional TPS repair. Twelve porcine tibiae (n = 6 each) TG group: flexor digitorum profundus tendon was passed through an incision in the root area, created 5 mm postero-medially along the edge of the attachment area. TPS group: a modified Mason-Allen suture was created using no...
2018: PloS One
Charlie Michaudet
Pes planus or pes planovalgus (ie, flatfoot) is a common condition among young children and also is encountered in adults. In children, congenital pes planus typically resolves with age as the foot musculature strengthens. Flexible pes planus is defined as a normal arch during non-weight-bearing activity or tiptoeing, with a flattening arch on standing. In rigid pes planus, the arch remains stiff and collapsed with or without weight bearing. Patients with rigid pes planus should be referred for subspecialist treatment...
February 2018: FP Essentials
Birnur Yilmaz
OBJECTIVE: To investigate the value of Acoustic Radiation Force Impulse elastography and its application in Achilles tendon elasticity of intermittent claudication due to lower extremity arterial ischaemia. METHODS: This prospective case-control study was conducted at the Department of Radiology, Faculty of Medicine, Baskent University, Istanbul, Turkey, from October 2015 to January 2016, and comprised bilateral Achilles tendons of patients with intermittent claudication and healthy individuals...
January 2018: JPMA. the Journal of the Pakistan Medical Association
Wesley Zhang Yang, Joseph S Park, Seth Robert Yarboro
CASE: A 47-year-old Caucasian woman spontaneously developed an isolated anterior compartment pressure of >100 mm Hg in the left leg. Despite fasciotomies, the musculature was nonviable and required debridement. Following Achilles tendon lengthening, a posterior tibial tendon (PTT) to anterior tibial tendon (ATT) transfer was supplemented with a flexor digitorum longus tendon transfer to the remaining PTT in order to prevent a flatfoot deformity while restoring active dorsiflexion. CONCLUSION: Preservation of the tendinous portion of the ATT during debridement allowed for transfer of the PTT to the ATT using a modified Pulvertaft transfer...
January 24, 2018: JBJS Case Connector
Priscilla Tu
The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. Other causes of plantar heel pain include calcaneal stress fractures (progressively worsening pain after an increase in activity or change to a harder walking surface), nerve entrapment or neuroma (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), and plantar warts...
January 15, 2018: American Family Physician
Domenico Albano, Nicolò Martinelli, Alberto Bianchi, Giovanni Romeo, Gaetano Bulfamante, Massimo Galia, Luca Maria Sconfienza
OBJECTIVE: To investigate the correlation between MRI, clinical tests, histopathologic features of posterior tibial tendon (PTT) dysfunction in patients with acquired adult flatfoot deformity surgically treated with medializing calcaneal osteotomy and flexor digitorum longus tendon transposition. MATERIALS AND METHODS: Nineteen patients (11 females; age: 46 ± 15 year, range 18-75) were pre-operatively evaluated using the single heel rise (HR) and the first metatarsal rise (FMR) sign tests...
February 2018: European Journal of Radiology
Dhong Won Lee, Russel Haque, Kyu Sung Chung, Jin Goo Kim
There have been several techniques to repair the medial meniscus posterior root tears (MMPRTs) with the goal of restoring the anatomic and firm fixation of the meniscal root to bone. Many anatomic studies about the menisci also have been developed, so a better understanding of the anatomy could help surgeons perform correct fixation of the MMPRTs. The meniscal roots have ligament-like structures that firmly attach the menisci to the tibial plateau, and this structural concept is important to restore normal biomechanics after anatomic root repair...
August 2017: Arthroscopy Techniques
K-T Kang, Y-G Koh, J Son, O-R Kwon, J-S Lee, S K Kwon
OBJECTIVES: Posterior condylar offset (PCO) and posterior tibial slope (PTS) are critical factors in total knee arthroplasty (TKA). A computational simulation was performed to evaluate the biomechanical effect of PCO and PTS on cruciate retaining TKA. METHODS: We generated a subject-specific computational model followed by the development of ± 1 mm, ± 2 mm and ± 3 mm PCO models in the posterior direction, and -3°, 0°, 3° and 6° PTS models with each of the PCO models...
January 2018: Bone & Joint Research
Yasutaka Tashiro, Ken Okazaki, Koji Murakami, Hirokazu Matsubara, Kanji Osaki, Yukihide Iwamoto, Yasuharu Nakashima
AIM: To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BTB) autografts, and to clarify the influence of tunnel positions on the knee stability. METHODS: Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial (TT) ( n = 20) and trans-portal (TP) ( n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3D-CT bone models two weeks after surgery...
December 18, 2017: World Journal of Orthopedics
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